Very Worried - Unprotected Sex followed by Mono type symptoms

Dear Doctor

3.5 weeks ago I had an encounter with a Turkish protsitute in London which consisted of cunilingus and then penatrative sex without a condom. I showered immediately before and immediately after the encounter.  Stupid, what can I say.  At the time I noticed the lady was quite sweaty, but as this is a problem I have suffered from all my life did not give it a second thought. Two days after meeting, I contacted the lady by email and asked her if she had any viruses. etc which I should be aware of - she said she was regularly tested and was clear and healthy.  Why would she lie, but there again why not?

10 days after this meeting, I developed a sore throat.  This has now lasted on an off for two weeks.  Throughout this period I have had rasied glands in the front triangle of my neck, primarilly on the right hand side.  

I am suffering some discomfort in my ears, this is like a mild pressure causing a dull ache - I can "pop" my ears by holding my nose and breathing out.  

I have had a series of headaches over the past weeks, mild and generally in the temples.  

I have also experienced a four of events of diarrhea, the first one lasted a day and was quite violent.  Yesterday my throat got worse and I noticed I had ulsers on the roof of my mouth at the rear. Finally, I have had a stiff neck, also more prominant on the right hand side to the rear and paralel to my spine.

Being more than a little anxious since the encounter, I have been taking my temperature on a regular basis - ranging from hourly to four times a day.  Over this period I noted my temperature ranged from 36.45C to 37.93C (rectal) - higest in the mid/late afternoon and lowest early in the morning just after I woke up.  For your information, I have noted historically that my temperature tends to run on the high side, and I accept that the definition of normal temperature can vary quite a lot from person to person.


I am very worried that I have contracted HIV; I have read a lot of the questions and responses posted on this site, and read a wealth of information (or dissinformation)else where on the internet. In particular, I have seen that oral ulcers are a defining symptom of primary/acute HIV infection.  This has scared me to death.  I note that you say a blood test at 4 week is ~80% accurate; I have booked one for tomorrow. Now I note from one article that the tests vary in accuracy - which test should I be having at this point in time, accepting that if the result is negative a second test at 3mnth will give absolute confirmation of the status.

Oh, I guess that I should mention I am currently between jobs having been made redundant and am selling my house to relocate out of London.  These factors will, of course, add to my stress levels and may influence my mood.

Please forgive my spelling, I hope that the above is a clear presentation of my situation and enables you to answer me.

Yours sincerely


London Tom

[H. Hunter Handsfield, M.D.]

Your symptoms almost certainly are coincidental with the sexual encounter you describe--unless you caught a garden-variety respiratory virus from her.  Your sexual encounter was safe (condom) and, as you suggest, she almost certainly isn't infected with HIV.  Sweatiness during sex is irrelevant; HIV does't appear in sex, even if whe was infected.

So the odds are very strong your HIV test will be negative.  The test results will be a far more reliable indicator of HIV infection than your symptoms; so many other things, all more common than HIV, cause the same sorts of symptoms.  And your symptoms don't sound much like HIV anyway.  Yes, 4 weeks is a bit early for testing, but even then, the negative result will be quite reassuring.  You can then have a second test 6-12 weeks later to be that much more certain.

Everybody's body temperature varies like yours has been doing; 98.6 is just the average.  Like you, most people's temperature is highest in late afternoon and evening and lowest on arising in the morning, with 1-2 degrees between the two, sometimes as much as 3 degrees.

Good luck-- HHH, MD

[London Tom]

Doctor, forgot to mention I am not circumcised and I have been feeling nausious.

London Tom

[H. Hunter Handsfield, M.D.]

Circumcision status and nausea don't change my response.  Even though being uncircumcised raises the risk of HIV if exposed, doubling a risk of almost zero still leave the risk at almost zero.

HHH, MD

[Alias Lola]

Pardon me for chiming in, Doctor, but he said his exposure was without a condom.

[HHH,MD]

Sure enough-- sorry I misread it.  Thanks for catching the error, A.L

But it doesn't change my response in any important way, since the likelihood of HIV transmission is so low during any particular episode of vaginal sex, even unprotected and even if she were HIV positive.

HHH, MD

[scaredstraight68]

When you say 6-12 weeks are you saying anytime after 6 weeks is the  same as or close to 12? And why does Mass insist that 6 weeks is enough time?  Do they know something we don't?  They did win the World Series and all.

[London Tom]

Dear Doctor

I am most grateful for your comments, this is indeed reassuing.  

It is my intention to have another test in the 12th week for abosolute certainty so tomorrow is one step in overcomming my concerns.

Could I ask what comment you have on the oral ulcer issue, I recognise that there is a lot of rubbish posted on the internet about various conditions (including HIV). I take it from you very robust response that you do not consider oral ulcers such a relaible differential symptom of accute HIV, is this correct?

Am I right in taking it you do not consider cunnilingus a risk factor? Many other sites take a far less robust view, sugesting that this indeed may be a risk factor.

Once again thanks for your response, and thanks to others for spotting your deliberate error on the protection front - or lack thereof.

London Tom

[Imdumb]

I don't think anyone has ever gotton HIV from cunninglas.  In the history of the virus, you would be hard pressed to find a confirmed transmission.

[Alias Lola]

Hey, as a New Yorker and die-hard Yankee fan, I take umbrage at that remark!  :oP

[JohnnyV]

You tell him, Lola! Maybe the Yankees didn't win the last World Series but at least we're not nicknamed Beantown.

J

[dodgeman]

did you ever wonder what the three month mark really is....is it 90 days or is it 84.......does anyone really know>? you also hear people quote 13 weeks till certainty....

[tbug]

jonnyv,i have a question.i know your knowledge about hiv is better than mine.i had my last test at 12 weeks 3 days (hiv test).an it was negative,thank god.but i have a lympenode swelling in my left area neck.which aches down into my shoulders an so on.i know 12 weeks is good enough testing,but im going into my third shot for hep-b vaccine.can this vaccine cause this to be enlarged an only in my left side of my neck?should i get tested for hiv again?should i not get the last shot for hep-b.do you have any data on the hep-b vaccine.im really aching an feel like **** an don't know if this is the cause of it.the doc still says i should get the last shot(2 docs).i've had a rash like on my thighs/legs/an butt.it never last more than 2 days.about three times out a four month period.i don't know what to do man?do you have any data on this.i whould appreciate it if you helped me out.thanks tbug....

[JohnnyV]

I'm sorry, but I don't know anything about the results of hep. This looks like a mission for a doctor, or maybe someone else on the forum who knows more about it. Accept my support and best wishes, though!

[jimmyhoots]

Hey, i just had unprotected sex with a girl that i belive kinda got around, if you know what i mean. We had sexual intercourse without the use of a condom. After 5 days i developed a soar throat and i keep gettin hot n cold flashes (might be due to my mind cause im so scared) but i got a soar throat and im very worried!! how long do i hafta wait until i get tested? 4 weeks?

p.s  i had sex with another gurl that i care about 4 days after this encounter and i was wondering if i could trasmited hiv to her if i was infected 4 days earlier?????? VERY CONCERNED PLZ Answer my question i dont have 10 $ to post new question :S:S:S plz answer.

[scaredstraight68]

I'll say what the doc would probably say.  Symptoms mean nothing.  The odds are highly in your favor, 1-1000 if she is infected.  You can get a 3-4 week HIV test which will be pretty reliable or wait a couple more weeks for a 6 week test which is pretty much an indicator for vaginal sex.  For piece of mind you can get a 12 week but it will undoubtedly the same as your six week.  Until you test think about either not having any more sex or using protection.

Hows that doc.

[London Tom]

FYI I had a ELISA test last night, results were negative.  Visit to GP this morning for general check up, he does not think my throat is a Strep type infection and confirmed that the symptoms of the problem were declining.  It has been a worrying period for me, I am still not out of the woods - will need to wait another 2 months for the 99.99% test at 3 months.  All you out there, please be careful, life is short at best and there is absolutely no sense in reducing either your own on someone else's life.

[Alias Lola]

My sentiments exactly.  Beantown???!! Geeeez